Erfelijk prostaatcarcinoom

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Acute buik: denk aan de blaas.

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The impact of prostate cancer diagnosis and treatment decision-making on health-related quality of life before treatment onset

Contains fulltext : 184198.pdf (publisher's version ) (Open Access)Objective: The objective of this study is to test if patients’ health-related quality of life (HRQoL) declines after prostate biopsy to detect Pca, and after subsequent treatment decision-making in case Pca is confirmed, and to test whether personality state and traits are associated with these potential changes in HRQoL. Methods: Patients who were scheduled for prostate biopsy to detect Pca (N = 377) filled out a baseline questionnaire about HRQoL (EORTC QLQ-C30 and PR25), "big five" personality traits (BFI-10), optimism (LOT-r), and self-efficacy (Decision Self-efficacy Scale) (t0). Patients with confirmed Pca (N = 126) filled out a follow-up questionnaire on HRQoL within 2 weeks after treatment was chosen but had not yet started (t1). Results: HRQoL declined between t0 and t1, reflected in impaired role and cognitive functioning, and elevated fatigue, constipation, and prostate-specific symptoms. Sexual activity and functioning improved. Baseline HRQoL scores were unrelated to the selection of a particular treatment, but for patients who chose a curative treatment, post-decision HRQoL showed a greater decline compared to patients who chose active surveillance. Optimism was associated with HRQoL at baseline; decisional self-efficacy was positively associated with HRQoL at follow-up. No associations between HRQoL and the "big five" personality traits were found. Conclusion Patients who have undergone prostate biopsy and treatment decision-making for Pca experience a decline in HRQoL. Choosing treatment with a curative intent was associated with greater decline in HRQoL. Interventions aimed at optimism and decision self-efficacy could be helpful to reduce HRQoL impairment around the time of prostate biopsy and treatment decision-making.8 p

Patient-reported outcomes for patients undergoing radical cystectomy: A prospective case-control study

Purpose The purpose of this study was to measure patient-reported outcomes (PROs) for patients with muscle-invasive bladder cancer (BC) before the diagnosis of BC was known, thus before cystectomy, and until 1 year postcystectomy. The differences in outcomes between a health status (HS) and quality of life (QoL) questionnaires were examined. Methods From July 2007 to July 2010, 598 patients with primary hematuria were enrolled in this prospective, multi-centre case–control (CC) study. Patients undergoing radical cystectomy (RC; N = 18) were compared with patients with other causes of hematuria (CC, N = 20). Measurement points were before diagnosis as well as 3, 6 and 12 months postcystectomy. Questionnaires used were the WHOQOL-BREF, SF-12, International Index of Erectile Function, and 10-item STAI-Trait scale. Results Prediagnosis patients who later appeared to have BC had the same QoL compared to CC patients. The prediagnosis physical component scale of HS and sexual function were significantly lower for RC vs. CC patients. RC patients had a better prediagnostic QoL and HS than postcystectomy at all time points. Conclusions This is the first case–control study with a baseline measurement of PROs before the diagnosis of BC was known. It shows lower physical health and sexual function for RC vs. CC before diagnosis is known. Until 1 year postcystectomy, QoL does not return to baseline level. Future studies including comorbidity and smoking history are needed to examine the generalizability of our results. Keywords: Muscle-invasive bladder cancer, WHOQOL-BREF, Quality of life, Cystectom

Pre-diagnosis quality of life (QoL) in patients with hematuria: Comparison of bladder cancer with other causes

Purpose To examine quality of life (QoL), health status, sexual function, and anxiety in patients with primary hematuria who later appear to have bladder cancer (BC) and patients with other diagnoses. Methods From July 2007 to July 2010, 598 patients with primary hematuria were enrolled in this prospective, multicenter study. Questionnaires (WHOQOL-BREF, SF-12, IIEF, STAI-10-item Trait) were completed before cystoscopy. Diagnosis was subsequently derived from medical files. BC patients were compared with patients with other causes of hematuria. Results Cancer was diagnosed in 131 patients (21.9 %), including 102 patients (17.1 %) with BC. No differences were found in the WHOQOL-BREF versus SF-12 psychological or physical health domains. The erectile function was significantly worse in the BC group (9.3 vs. 14.6 for OC, p = 0.02). Patients with muscle-invasive BC (MIBC) had the lowest percentage anxious personalities of all BC patients (p = 0.04). Conclusions Cancer was found in 21.9 % of the patients with hematuria. Pre-diagnosis patients with BC have comparable QoL and HS to patients with OC. Erectile dysfunction was highest in patients with BC. MIBC patients had the lowest percentage anxious personalities of the patients with BC. Keywords: Quality of life, Health status, Hematuria, Bladder cancer, Erectile dysfunctio

[Characterisation of families with hereditary prostate cancer in the Netherlands]

Item does not contain fulltextOBJECTIVE: To inventory the characteristics of Dutch families with hereditary prostate carcinoma (HPC). DESIGN: Descriptive. METHOD: From a national registry of families that meet the criteria of HPC, information was collected about patients with HPC and their first-degree relatives from 1995 through to 30 June 2001. The ages of the HPC patients at diagnosis were compared with those of all patients with prostate cancer in the Dutch population during the period 1990 to 1996. The cumulative risk of prostate cancer for HPC families was calculated on the basis of the ages of the patients with prostate cancer and their first-degree male relatives. RESULTS: A total of 70 families fulfilled the criteria. The families included 273 patients with prostate cancer. The diagnosis had been confirmed in 208 (76%) of these patients. Two cases of prostate cancer were observed in 3 families, 3 cases were found in 31 families, and in the remaining families 4-8 cases of prostate cancer were observed. The mean age at diagnosis of prostate cancer was 65.5 years (range: 46-89). Of the 273 HPC patients, 128 (47%) were younger than 65 years at the time of diagnosis, whereas in unselected cases of prostate cancer this figure was 16%. The risk of developing prostate cancer before the age of 70 years for members of HPC families was 39%. The mean age of death due to prostate cancer was 71 years (54-84). The mean value of prostate specific antigen (PSA), known for 47 (17%) of the HPC patients, was 36.8 ng/ml (2.1-280)